Costs and usage of healthcare services before and after open bariatric surgery.

CONTEXT AND OBJECTIVE: Morbidly obese individuals are major consumers of healthcare services, with high associated costs. Bariatric surgery is an alternative for improving these individuals' comorbidities. There are no studies comparing costs before and after bariatric surgery in Brazil. The aim here was to analyze results relating to healthcare usage and direct costs among morbidly obese patients undergoing bariatric surgery. DESIGN AND SETTING: Historical cohort study on patients receiving healthcare through a private health plan in Belo Horizonte, Minas Gerais. METHODS: All healthcare services and their associated costs were included in the analysis: hospitalization, hospital stay, elective outpatient consultations, emergency service usage and examinations. The analyses were treated as total when including the whole years before and after surgery, or partial when excluding the three-month periods adjacent to the operation. RESULTS: For 382 obese patients who underwent open bariatric operations, there were 53 hospitalizations one year before and 95 one year after surgery (P = 0.013). Gastrointestinal complications were the main indications for post-procedure hospitalizations. The partial average cost almost doubled after the operation (US$ 391.96 versus US$ 678.31). In subgroup analysis, the costs from patients with gastrointestinal complications were almost four times greater after bariatric surgery. Even in the subgroup without complications, the partial average cost remained significantly higher. CONCLUSION: Although bariatric surgery is the only path towards sustained weight loss for morbidly obese patients, the direct costs over the first year after the procedure are greater. Further studies, with longer follow-up, might elucidate whether long-term reversal of this trend would occur.

Costs and usage of healthcare services before and after open bariatric surgery / Custos e utilização de serviços de saúde antes e após a cirurgia bariátrica por laparotomia

CONTEXT AND OBJECTIVE: Morbidly obese individuals are major consumers of healthcare services, with high associated costs. Bariatric surgery is an alternative for improving these individuals' comorbidities. There are no studies comparing costs before and after bariatric surgery in Brazil. The aim here was to analyze results relating to healthcare usage and direct costs among morbidly obese patients undergoing bariatric surgery. DESIGN AND SETTING: Historical cohort study on patients receiving healthcare through a private health plan in Belo Horizonte, Minas Gerais. METHODS: All healthcare services and their associated costs were included in the analysis: hospitalization, hospital stay, elective outpatient consultations, emergency service usage and examinations. The analyses were treated as total when including the whole years before and after surgery, or partial when excluding the three-month periods adjacent to the operation. RESULTS: For 382 obese patients who underwent open bariatric operations, there were 53 hospitalizations one year before and 95 one year after surgery (P = 0.013). Gastrointestinal complications were the main indications for post-procedure hospitalizations. The partial average cost almost doubled after the operation (US$ 391.96 versus US$ 678.31). In subgroup analysis, the costs from patients with gastrointestinal complications were almost four times greater after bariatric surgery. Even in the subgroup without complications, the partial average cost remained significantly higher. CONCLUSION: Although bariatric surgery is the only path towards sustained weight loss for morbidly obese patients, the direct costs over the first year after the procedure are greater. Further studies, with longer follow-up, might elucidate whether long-term reversal of this trend would occur.

CONTEXTO E OBJETIVO: Indivíduos obesos mórbidos são grandes consumidores de serviços de saúde, com altos custos associados. A cirurgia bariátrica é uma alternativa para melhorar suas comorbidades. Não existem estudos comparando custos antes e após a cirurgia bariátrica no Brasil. O objetivo deste estudo foi analisar os resultados assistenciais e gastos diretos de pacientes obesos mórbidos submetidos à cirurgia bariátrica. TIPO DE ESTUDO E LOCAL: Coorte histórica de pacientes assistidos por um plano de saúde na cidade de Belo Horizonte, Minas Gerais. MÉTODOS: Foram incluídos na análise todos os serviços de saúde e seus custos associados: hospitalizações, permanência hospitalar, consultas eletivas e de emergência e exames. A análise foi tratada como total quando incluía todo o ano anterior e posterior à cirurgia, e parcial quando excluía os trimestres adjacentes à cirurgia. RESULTADOS: Para 382 pacientes obesos operados, houve 53 internações um ano antes e 95 um ano após a cirurgia (P = 0,013). As principais indicações para internação pós-procedimento foram complicações relacionadas ao trato gastrointestinal. O custo parcial médio quase dobrou no período pós-operatório (US$ 391,96 versus US$ 678,31). Em análise de subgrupo, pacientes com complicações do trato gastrointestinal apresentaram custos quase quatro vezes maiores no período pós-bariátrica, e mesmo no subgrupo sem estas complicações, o custo parcial médio permaneceu significativamente maior. CONCLUSÃO: Embora a cirurgia bariátrica seja o único caminho para perda de peso sustentada nos pacientes obesos mórbidos, os custos diretos até um ano pós-procedimento são maiores. Novos estudos, com maior tempo de acompanhamento, poderão verificar se essa tendência se reverte no longo prazo.

Oral language comprehension assessment among elderly: a population based study in Brazil.

BACKGROUND: Determinants of oral language comprehension, a complex skill, are not clearly established, but may include age, schooling, health condition, depression and quality of life. OBJECTIVE: To assess oral comprehension skill among Brazilian elderly and identify factors explaining elderly variability in the Token test performance. METHODS: A population-based random sample of 373 elderly (> or = 60 years) in Belo Horizonte, 2007, answered standardized questionnaire including socio-demographic and health-related questions and performed the Token Test short version (SVTT), Snellen Test, Mini Mental State Examination, General Health Questionnaire, and Health Survey Short Form (SF12). RESULTS: Token Test scores ranged from 8 to 35 points; 50% of participants scored < or = 24 points with no sex variation. Age, schooling, literacy, cognitive status, hypertension, self-rated conversational understanding and SF12 mental component explained 62% of SVTT variability. CONCLUSIONS: Language comprehension disorder was quite common and test performance was highly influenced by education and cognitive status. Association between test performance and self-rated conversational comprehension indicated that elderly were aware of their difficulty.

Efetividade da vacina antiamarílica 17D: uma avaliação epidemiológica em serviços de saúde

Estudo que avalia a efetividade da vacina antiamarílica em um grupo de estudantes da cidade mineira de Bocaiúva. Com tabela. Artigo publicado na Revista Panamericana de Salud Pública de agosto de 1997.

Mortality and hospital stay after bariatric surgery in 2,167 patients: influence of the surgeon expertise.

BACKGROUND: Postoperative mortality is a rare event after bariatric surgery. The main goal of this study was to calculate the 30-day mortality rate postbariatric "open" surgery and the length of hospital stay of patients assisted by a health maintenance organization in Brazil. We also investigate their association with sex, age, BMI, preexisting comorbidities, and volume of procedures performed by surgeons. METHODS: A total of 2,167 patients who underwent RYGB between 01/2004 and 12/2007 were analyzed. The deaths and hospital stay were identified in the healthcare transactional database and the morbidity data in the preoperative medical audit records. Factors contributing to adverse outcomes were determined by multiple logistic regression analysis. RESULTS: The overall mortality rate was 0.64%, with a decreasing trend over the years. The median hospital stay was 3.1 days. In the multivariate analysis, both mortality and longer hospital stay were positively and significantly associated with age > 50 years, BMI > 50 kg/m(2), and surgeon volume of less than 20 bariatric surgeries/year. Presence of hypertension also increased the risk of longer hospital stay. Multivariate analysis showed that the 30-day mortality was six times higher in patients operated by professionals who performed less surgeries/year and longer hospital stay, four times more frequent. CONCLUSIONS: The 30-day mortality post-RYGB is similar to the rates found in developed countries and much lower than the rates found for patients assisted by the public health system in Brazil. In addition to age and clinical factors, the results suggest that mortality and longer hospital stay are strong and inversely related to surgeon's experience.

[The hospital bed referral center under the Unified National Health System in Belo Horizonte, Minas Gerais State, Brazil: the case of hospitalization for ischemic heart disease]. / Central de regulação de leitos do SUS em Belo Horizonte, Minas Gerais, Brasil: avaliação de seu papel pelo estudo das internações por doenças isquêmicas do coração.

The hospital admissions center in Belo Horizonte, Minas Gerais State, Brazil, aims to assure fast, timely, and equitable access to hospitalization services through the Unified National Health System. However, many patients are admitted directly to the hospitals, without going through the admissions center. This study compared the characteristics of hospitalizations in Belo Horizonte in 2002 according to type of access. All admissions for acute myocardial infarction and acute coronary disease were included. Of 3,705 admissions, 24.9% were processed through the hospital admissions center and 75.1% through direct access. Direct hospitalizations were more common as compared to processing by the hospital admissions center for patients>70 years), those with presumptive diagnosis of acute coronary disease, to the surgical department, and on weekends. Admissions via the hospital admissions center were more common than direct access for patients residing outside Belo Horizonte, at non-public hospitals, and for the intensive care unit. Length-of-stay also varied according to type of access. The results confirm differences in the characteristics of admissions according to the two types of access.

Hospital admission and hospital death associated to ischemic heart diseases at the National Health System (SUS).

BACKGROUND: Analyses on mortality rate due to diseases when outcome depends on proper, timely medical intervention may point out the vulnerabilities and inequity associated to health care access. Ischemic heart diseases will act as models for such assessment. OBJECTIVE: The present study investigates factors associated to the hospital death rate of patients admitted to hospital due to acute myocardial infarction (AMI) and heart failure (HF), and whether admittance through Belo Horizonte Municipal Health Office (SMSA-BH) Admission Center (AC) was in any way associated to hospital death after adjustment of relevant factors. METHODS: Data obtained from the Hospital Admission Authorizations (AIH) and requests for hospital beds at SMSA data base on latest hospital admissions based on AMI or HF diagnostic hypotheses. Multivariate analysis was conducted to investigate risk factors for hospital death. RESULTS: No association was found between hospital admittance access and hospital death risk from those causes. Multivariate analysis showed higher death risk for 60 and 60+ year-old patients (OR=2.9), AMI diagnostic hypothesis (OR=3.0), the need for ICU care (OR=1.6), females (OR=1.4), surgery type (OR=1.9), and public health service hospital (OR=3.5). Hospital admissions due to AMI on weekends also showed higher death risk for death (OR=1.7). CONCLUSION: Further investigation is necessary in order to evaluate the kind of medical assistance provided on weekends at public hospitals. Other hospital factors are to be taken into account, as well as patients and assistance procedures, as subsidies for proposals to ensure higher equity and quality standard for public health services.

Central de regulação de leitos do SUS em Belo Horizonte, Minas Gerais, Brasil: avaliação de seu papel pelo estudo das internações por doenças isquêmicas do coração / The hospital bed referral center under the Unified National Health System in Belo Horizonte, Minas Gerais State, Brazil: the case of hospitalization for ischemic heart disease

A Central de Internações de Belo Horizonte, Minas Gerais, Brasil, visa tornar ágil o acesso às internações pelo Sistema Único de Saúde (SUS). Entretanto, muitas internações ocorrem diretamente nos hospitais, sem intermediação da Central de Internação. O estudo comparou as características das internações realizadas em 2002, com relação à via de acesso. Foram selecionadas internações com hipótese diagnóstica de infarto agudo do miocárdio e insuficiência coronariana aguda. De 3.705 internações, 24,9 por cento foram realizadas pela Central de Internação e 75,1 por cento por via direta. As proporções de internações via direta foram maiores que pela Central de Internação para pacientes > 70 anos, internados por insuficiência coronariana aguda, na clínica cirúrgica e no fim de semana. Os percentuais das internações via Central de Internação foram maiores que os feitos por via direta para residentes em outros municípios, em hospitais não públicos e com utilização de UTI. O número de dias de internação também foi diferente entre as vias. O estudo mostrou diferenças nas características das internações realizadas pelas duas vias de acesso.

The hospital admissions center in Belo Horizonte, Minas Gerais State, Brazil, aims to assure fast, timely, and equitable access to hospitalization services through the Unified National Health System. However, many patients are admitted directly to the hospitals, without going through the admissions center. This study compared the characteristics of hospitalizations in Belo Horizonte in 2002 according to type of access. All admissions for acute myocardial infarction and acute coronary disease were included. Of 3,705 admissions, 24.9 percent were processed through the hospital admissions center and 75.1 percent through direct access. Direct hospitalizations were more common as compared to processing by the hospital admissions center for patients > 70 years ), those with presumptive diagnosis of acute coronary disease, to the surgical department, and on weekends. Admissions via the hospital admissions center were more common than direct access for patients residing outside Belo Horizonte, at non-public hospitals, and for the intensive care unit. Length-of-stay also varied according to type of access. The results confirm differences in the characteristics of admissions according to the two types of access.

Acesso à internação e fatores associados ao óbito hospitalar por doenças isquêmicas do coração no SUS / Hospital admission and hospital death associated to ischemic heart diseases at the National Health System (SUS)

FUNDAMENTO: Análises de mortalidade por doenças cujo desfecho depende de intervenção médica adequada e oportuna permitem apontar fragilidades e desigualdades de acesso no cuidado à saúde. Doenças isquêmicas do coração servem como modelo para essa avaliação. OBJETIVO: O estudo investiga os fatores associados ao óbito hospitalar nas internações por infarto agudo do miocárdio (IAM) e insuficiência coronariana (IC), e se a via de internação pela Central de Internação (CI) da Secretaria Municipal de Saúde de Belo Horizonte (SMSA-BH) esteve associada ao óbito hospitalar após ajuste por fatores relevantes. MÉTODOS: Dados obtidos das Autorizações de Internações Hospitalares (AIH) e dos laudos e pedidos de vaga para internações da SMSA sobre a última internação realizada com hipótese diagnóstica de IAM ou IC. Análise multivariada foi realizada para identificar fatores de risco para o óbito hospitalar. RESULTADOS: Não houve associação entre via de acesso à internação e risco de óbito hospitalar por essas causas. Análise multivariada demonstrou maior risco de óbito para pacientes com 60 anos de idade ou mais velhos (odds ratio [OR] = 2,9), hipótese diagnóstica de IAM (OR = 3,0), uso de Unidade de Terapia Intensiva [UTI] (OR = 1,6), sexo feminino (OR = 1,4), especialidade cirúrgica (OR = 1,9) e hospital público (OR = 3,5). Nas internações por IAM, houve também maior risco de morte de pacientes internados no fim de semana (OR = 1,7). CONCLUSÃO: Novas investigações são necessárias para avaliar a assistência prestada nos finais de semana e a realizada nos hospitais públicos, levando em consideração outros fatores dos hospitais, dos pacientes e do processo da assistência, para subsidiar propostas que garantam maior eqüidade e maior qualidade da assistência pública.

BACKGROUND: Analyses on mortality rate due to diseases when outcome depends on proper, timely medical intervention may point out the vulnerabilities and inequity associated to health care access. Ischemic heart diseases will act as models for such assessment. OBJECTIVE: The present study investigates factors associated to the hospital death rate of patients admitted to hospital due to acute myocardial infarction (AMI) and heart failure (HF), and whether admittance through Belo Horizonte Municipal Health Office (SMSA-BH) Admission Center (AC) was in any way associated to hospital death after adjustment of relevant factors. METHODS: Data obtained from the Hospital Admission Authorizations (AIH) and requests for hospital beds at SMSA data base on latest hospital admissions based on AMI or HF diagnostic hypotheses. Multivariate analysis was conducted to investigate risk factors for hospital death. RESULTS: No association was found between hospital admittance access and hospital death risk from those causes. Multivariate analysis showed higher death risk for 60 and 60+ year-old patients (OR=2.9), AMI diagnostic hypothesis (OR=3.0), the need for ICU care (OR=1.6), females (OR=1.4), surgery type (OR=1.9), and public health service hospital (OR=3.5). Hospital admissions due to AMI on weekends also showed higher death risk for death (OR=1.7). CONCLUSION: Further investigation is necessary in order to evaluate the kind of medical assistance provided on weekends at public hospitals. Other hospital factors are to be taken into account, as well as patients and assistance procedures, as subsidies for proposals to ensure higher equity and quality standard for public health services.

Parkinsonism and Parkinson's disease in the elderly: a community-based survey in Brazil (the Bambuí study).

Several community-based surveys on the prevalence of Parkinsonism and Parkinson's disease have been conducted worldwide, with variations on their methodology and results. The objective of this study is to assess the prevalence of Parkinsonism and its causes in a cohort of individuals age 64 years or older in Bambuí, a Brazilian town. In phase I, 1,186 people older than 64 years responded to a 9-question screening questionnaire for Parkinsonism. In phase II, all subjects who scored > or = 2 points on the test were examined independently by at least 2 movement disorder-trained physicians. A movement disorder senior specialist excluded or confirmed the diagnosis in all suspected cases. The response rate was high for both phases (96% for phase I and 94% for phase II). The prevalence rate per 100 population over 64 years of age in this group was 7.2% for Parkinsonism of all types (n = 86). The most frequent causes were idiopathic Parkinson's disease and drug-induced Parkinsonism, with prevalence rates of 3.3% (n = 39) and 2.7% (n = 32), respectively. The prevalence of vascular Parkinsonism was 1.1% (n = 13). We found 1 case of posttraumatic Parkinsonism and another with multiple system atrophy. In this first population-based study of Parkinsonism conducted in Brazil, the prevalence in a cohort of elderly subjects was higher than the observed in other populations worldwide, especially because of the high rates of drug-induced and vascular Parkinsonism. The prevalence of Parkinson's disease was similar to that observed in elderly people in door-to-door surveys in other American, European, and Eastern countries.

[Effects of detergents and disinfectants on the development of Ascaris lumbricoides eggs]. / Atividade de detergentes e desinfetantes sobre a evolução dos ovos de Ascaris lumbricoides.

Ascaris lumbricoides infection is acquired via ingestion of embryonated eggs of the parasite, thus justifying the search for ovicidal compounds. We studied the effect of 16 household and laboratory detergents and disinfectants on the embryogenesis of this helminth. Children carrying this infection were treated with levamisole. Eliminated female worms were collected and dissected to obtain eggs from the uteri. The eggs were placed in contact with various products at different dilutions and for various periods of time. After washing, eggs were incubated at 28 grades C for 20 days, for viability tests and to determine the embryonation rate. Only one product completely inhibited the embryonation of eggs at every dilution and for every time period tested. Five products inhibited more than 50% of embryonation, while six inhibited less than 50%. Three products showed no effect on embryonation, while for one the percentage of embryonated eggs was higher than in the control tubes.

Atividade de detergentes e desinfetantes sobre a evoluçäo dos ovos de Ascaris lumbricoides / Effects of detergents and disinfectants on the development of Ascaris lumbricoides eggs

A infecçäo por Ascaris lumbricoides decorre da ingestäo de ovos embrionados deste parasita, o que justifica a pesquisa de substâncias que tenham efeito deletério sobre estes ovos. Nosso objetivo foi estudar a açäo de 16 produtos detergentes e desinfetantes, de uso doméstico e laboratorial, sobre a embriogênese deste helminto. Crianças portadoras desta infecçäo foram tratadas com levamisol e os vermes fêmeas expelidos foram recolhidos e dissecados, para obtençäo dos ovos intra-uterinos. Os ovos foram postos em contato com os produtos em diversas diluições e tempos, lavados e incubados a 28ºC, por 20 dias, para teste da viabilidade e determinaçäo da porcentagem de embrionamento. Apenas um produto inibiu completamente o embrionamento dos ovos, em todos os tempos e diluições testados. Cinco produtos inibiram o embrionamento dos ovos em mais de 50 por cento, seis inibiram o embrionamento em menos de 50 por cento e três näo tiveram efeito sobre o embrionamento dos ovos. Por outro lado, com um produto observou-se aumento da porcentagem de embrionamento dos ovos em relaçäo aos controles

Prevalência de helmintos intestinais em três mesorregiões do Estado de Minas Gerais / Prevalence of intestinal helminths in three regions of Minas Gerais State

Foi realizado um levantamento das helmintoses intestinais em 18.973 escolares do primeiro grau (7 a 14 anos), da rede pública do Estado de Minas Gerais, utilizando o método de Kato-Katz de exame de fezes (duas lâminas por amostra). Foram estudadas 3 mesorregiöes: Triângulo Mineiro/Alto Paranaíba (60 municípios), Noroeste de Minas (13) e Sul/Sudoeste (144). Entre os escolares examinados, 15.545 (82 por cento) estavam negativos, 2.863 (15 por cento) monoparasitados e 565 (3 por cento) poliparasitados. A prevalência de A. lumbricoides foi de 10,3 por cento, de T. trichiura 4,7 por cento, de ancilostomídeos 2,9 por cento, de E. vermicularis 1,2 por cento, de H. nana 0,4 por cento e de Taenia sp 0,2 por cento. As maiores prevalências de helmintos/mesorregiäo foram de 24,2 por cento para T. trichiura e 18,7 por cento para A. lumbricoides (Sul/Sudoeste) e 12,1 por cento para ancilostomídeos e 0,7 por cento para Taenia sp (Noroeste de Minas). As helmintoses intestinais continuam sendo um grave problema de saúde pública, inclusive em áreas onde as condiçöes socioeconômicas säo mais favoráveis

The Bambuí Health and Aging Study (BHAS): private health plan and medical care utilization by older adults

O objetivo foi investigar se a cobertura de um plano privado de saúde afeta o uso de serviços médicos (consultas e hospitalizações) e o consumo de medicamentos entre idosos. Todos os residentes na cidade de Bambuí (Minas Gerais) com idade maior ou igual 60 anos (n = 1.742) foram selecionados. Destes, 92,2por cento e 85,9 por cento foram entrevistados e examinados (exames de sangue e medidas físicas), respectivamente. Após ajustamentos por variáveis de confusão, os idosos que dependiam dos serviços públicos (n = 1.296), em comparação aos que possuíam plano privado de saúde (n = 310), apresentaram evidências de pior condição de saúde, visitaram menos o médico e usaram menor número de medicamentos prescritos. A principal explicação para a cobertura de um plano privado foi econômica e não a condição de saúde. Embora a proporção dos que se queixaram dos serviços médicos tenha sido mais alta entre os que dependiam dos serviços públicos (70,9 por cento), esta queixa também foi importante entre os que possuíam plano de saúde privado (45,2 por cento relataram). O relato de dificuldades para adquirir medicamentos devido a problemas financeiros foi alto (25,2 e 47,2 por cento). Novas investigações são necessárias para determinar se estes resultados são generalizáveis para outras comunidades do país.

Internaçöes hospitalares entre idosos: o episóodio da Clínica Santa Genoveva e fatores associados à ocorrência de internaçöes em Bambuí, Minas Gerais / Internment hospitalisation among senior: the episode of Clinical Santa Genoveva and factors associated to the occurrence of internments in Bambuí, Minas Gerais

Estudo composto por 3 artigos. O primeiro investiga a mortalidade de idosos na Clínica Santa Genoveva, no Rio de Janeiro, onde morreram 156 idosos entre os meses de janeiro e maio de 1996, a maior taxa de mortalidade foi registrada em maio quando ocorreram 50 óbitos. Os dados do Sistema de Informaçöes Hospitalares do Sistema Unico de Saúde (SIH-SUS) foram utilizados para verificar se os óbitos representavam uma exceçäo ou refletiam condiçöes já existentes. O período estudado foi de maio de 1993 a maio de 1996. As taxas mensais de mortalidade da clínica foram comparadas às obtidas para o conjunto de 15 hospitais definidos como referência. Os resultados mostraram que a mortalidade já vinha ocorrendo desde 1993 e que a utilizaçäo adequada do SIH-SUS poderia ter antecipado o problema e evitado o excesso de mortalidade só identificado em meados de 1996. O 2 e 3 artigos, tratam da identificaçäo de fatores associados à ocorrência de internaçöes hospitalares entre idosos (>=60anos) vivendo na comunidade. Foram utilizados dados coletados do "Projeto Bambuí: estudo prospectivo com base populacional sobre envelhecimento", na cidade de Bambuí, Minas Gerais. No 2 artigo, foram investigadas as associaçöes existentes entre a ocorrência de uma ou mais internaçöes hospitalares nos últimos doze meses e variáveis indicadoras de predisposiçäo, facilitaçäo e necessidade de utilizaçäo de serviços de saúde. Associaçöes independentes com múltiplas internaçöes hospitalares foram verificadas com indicadores de predisposiçäo, de facilitaçäo e de necessidade. No 3 artigo foram estudadas as associaçöes entre a ocorrência de internaçöes hospitalares entre idosos e fatores biomédicos selecionados. Verificou se as variáveis permaneciam associadas à oorrência de internaçöes hospitalares entre idosos, após ajustamento pelas características de predisposiçäo, facilitaçäo e de necessidade. Conclui que a inclusäo de fatores biomédicos pouco afetou as associaçöes, entre a ocorrência de múltiplas internaçöes hospitalares e indicadores de predisposiçäo facilitaçäo e necessidade entre idosos. Os resultados confirmam observaçöes feitas em países desenvolvidos que informaçöes simples e de fácil obtençäo podem ser utilizadas para identificar idosos sob maior risco de internaçöes hospitalares. A aplicaçäo em saúde pública é a possibilidade de identificaçäo de idosos sob maior risco de internaçöes hospitalares e melhoria das suas condiçöes de saúde, através de tratamento precoce ou preventivo.

[Prevalence of intestinal helminths in three regions of Minas Gerais State]. / Prevalência de helmintos intestinais em três mesorregiões do Estado de Minas Gerais.

A parasitological assay of feces, through the Kato-Katz method, was undertaken in 18,973 schoolchildren (7 to 14 years old), at primary school level, from a public school of the State of Minas Gerais. Three mesoregions were studied: Tri ngulo Mineiro/ Alto Para ba ( 60 municipalities); northwest Minas Gerais (13) and south/south-west regions of Minas Gerais (144). Among the examined children, 15,545 (82%) were negative; 2,863 (15%) were infected with a single species of helminthes and 565 (3%) were infected by more than one species. The prevalence rates were: A. lumbricoides 10.3%; T. trichiura 4.7%; hookworm 2.9%; E. vermicularis 1.2%; H. nana 0.4% and Taenia sp 0.2%. The largest helminthes prevalence/mesoregion were for T. trichiura (24.2%) and A. lumbricoides (18.7%) in the south/south-west region; hookworm (12.1%) and Taenia sp (0.7%) in the northwest region of Minas Gerais. Intestinal helminthiasis is still regarded as a serious public health problem, including regions where the socio-economic conditions are more favorable.